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· Diminished ability to concentrate, think, or indecisiveness every day

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Part 1: Client Information

The client is a female of 30 years and is not married. She is African American and is living in the United States alone because her family is living in Africa. She has come to the United States to earn money and to establish her career because she got an education from her country and was a brilliant student in her educational field. She belongs to Christianity but she is not an active participant of the religion because she has faced different problems in her personal and professional life and now she feels that religion has not played a significant role in providing different facilities to her in her career. She is female and sexually interested in males but she has claimed that she wants to marry a White man from the United States to live a happy and satisfying life. Her family background belongs to the lower class but she has transferred it into the middle class by making effort and by focusing on her career. She does not have any disability and physically healthy and active both in her personal and professional life (Kendall, 2016).

She is living a financially stable life because she is working in a good organization as a marketing manager. More than ten employees are working under her supervision which showed that she has made her name in the business field due to her hard work and motivation of the work. She belongs to a poor family and wanted to make improvements in her financial status by her effort in the business field. Therefore, it can be said that the support system of the client is the family background that motivates her to perform well in the professional life. She has spent time with different boyfriends both Black and White but she did not become mentally attached and satisfied with them, therefore, she is living alone in the town. She is still working in one of the best organizations and her work is exemplary for other employees within the workplace. She is also physically stable and healthy and does not deal with any disease except diabetes due to which she is avoiding sugar for the last many years. The rate of diabetes has become increased in the United States; therefore, it is not a significant problem for her. She is not taking medication for the disease because she becomes able to control the disease with diet management and exercise, but she have a decrease in appetite. However, it can be said that she is physically healthy and active. 

The client is facing mental issues because she is not able to get a suitable partner for a happy and satisfied life. She is living alone in the town without her family for the past ten years because she came to the United States to make a career and money for herself. There is no doubt that she becomes able to make her career success and become a marketing manager in one of the famous organizations that were her major concern but she becomes unable to find the person with whom she can share her problems and happiness. She has a good connection with her family because she found that her parents and siblings have made contact with her just for money. She has tried a lot of time to find a suitable partner so that she becomes able to share her physical and mental needs with him. She has faced different problems in her professional life and no one was there in her back to support her which showed that she made all the progress alone. She has claimed that the main reason for mental distress is that no one in the world is emotionally attached to her. She has different friends but she cannot share her problems with them because there is not any strong bonding with any of them. She has different boyfriends with whom she tried to make good relations but no one from them was sincere with her due to which she left them. 

Different key events have a strong impact on the issue of the client but the most important event is that she has made good relation with her recent boyfriend but became separate due to some silly reasons. She also shared physical needs with her boyfriend which showed that he was physically and mentally attached to her. It has been found from the analysis that the main reason due to which she has not made good relation with anyone is that she is feared from the relations, therefore, she always runs away from serious relations. As a result, she has become a patient of mental disease and is facing different problems due to mental problems. 

Part 2: Theoretical Approach

There is a different theoretical approach that can be used for this case, but the most important approaches include cognitive theory, behavioral theory, and cognitive-behavioral theory. The most important theory that is directly linked with this case and is used for the patients of mental diseases includes behavior theory because it focused on the negative thought. It has been determined from the deep analysis of the case of the client that she is taking all the situations in her life negatively (Gerstner, 2020). She is focusing on negative thoughts such as she is considering that her family has made a connection with her only due to money. There is no doubt that she has made improvements in the financial status of her life but her family is connected with her when she was not successful in her career which showed that her family cares about her. She is taking this situation negatively just due to her mental condition. She has made different friends but she is thinking negatively that they are not sincere with her (Holliday, 2016). 

She has become mentally depressed due to her negative thoughts. One of the most significant thought that has changed her behavior is that she is from another country due to which she is Black while black people have to face different issues in new land especially in the United States. She had faced different issues in her personal and professional life due to her gender and skin color; therefore, she has become negative in all her thoughts. She was alone during a hard time because her family was not able to understand her situation and there was not any sincere person with which she could share her feelings, therefore, she has become depressed. She is not giving importance to any relationship due to her insecurities that have become developed in her personality due to problems that she has faced.  

She has different boyfriends in her past and some of them were also sincere with her but she has lost them due to her negative thoughts and behavior. Another theory that can be implemented in this case is a cognitive theory that has claimed that the thoughts of the people affect the emotions of the person. It has become clear from the analysis that her negative thoughts are negatively affecting the emotions of the client due to which her personal life is being disturbed. The case study has claimed that there is no major problem in the life of the client because there are different African Americans that are facing these issues but the problem with this case is that she was not able to manage it positively and had also negatively affected her emotions. 

The information that has been taken from the patient is beneficial for selecting the approach because it helps in determining the negative thoughts and reasons of negative thoughts that have created problems in her life. It helps in finding the theories that are linked with this case because history helps in determining the condition of the people. Thus it has become clear that the first step is important for the management of case studies.

Part 3: Assessment and Diagnosis

I have diagnosed from the analysis of the case study that the client is a patient of “Depression” because her condition is related to this disease. The definition of depression according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (Prather, 2016), is following 

“The person should be experiencing five or more than five symptoms from the last 2 weeks or at least one of the symptoms should be either loss of pleasure and interest, depressed mood”. The five symptoms should be present from the following list

· Depressed mood every day or most of the day

· Diminished or reduced the pleasure or interest in all or major activities nearly every day or most of the day

· Weight loss even not in dieting or weight gain or increase or decrease of appetite every day

· Loss of energy of fatigue every day

· Feeling or inappropriate or excessive guilt, or worthlessness every day

· Slowdown of the thought or reduction of physical movement that is observed by others 

· Diminished ability to concentrate, think, or indecisiveness every day

· Thoughts of death or recurrent suicidal ideation or a specific plan for committing the suicide 

I have arranged a face-to-face interview with the client so that client becomes able to share information. I have found from my experience that face-to-face meetings and interviews are more beneficial for the management of mental diseases as compared to online methods. Before the start of the session, I have a list of different questions that I asked from the client to determine his history and disease. The environment of a room where the session was conducted was attractive; therefore, the client becomes relaxed and gave all the information in detail without any problem. Thus I can say that I have gained all the information from the patient during the session. There is no doubt that there are chances of biases in the information but effective information has been collected in one session.

I have used symptom checklists that I usually used to determine the presence of depression in the patients and for the diagnosis of mental diseases. Five symptoms were present in the patient that claimed that the client was a patient of depression because it has been determined from the research that when two or more symptoms from the checklist are present then it indicates that the patient is dealing with depression. The symptoms that were present in the client include

· Depressed mood

· Decrease of appetite every day.

· Feeling or inappropriate or excessive guilt, or worthlessness every day

· Diminished ability to concentrate, think, or indecisiveness every day.

· Diminished or reduced the pleasure or interest in all or major activities nearly every day or most of the day.

Thus, it has become clear from the checklist that the client is dealing with depression. I have consulted with the parents of clients because the client was having a significant problem with her family especially her parents. Her negative emotions motivate me to ask their side so that it can become determined that either she is taking the situation more seriously or not. I have taken permission from her because it is ethically important to tell the whole situation to the patients to reduce problems in the future.

Different socio-culture factors were considered important during the diagnosis process from which one of the most common factors was her gender and skin color due to which she has to face different problems in her personal and professional life. I have diagnosed from the situation that the reason for the depression was the cultural and language difference and she becomes unable to manage the situation even after ten years (Keenan, 2014).

The information that I collected in the history phase of the patient helped in the diagnosis of the disease according to the theoretical approach because it was found in the history that she was taking all the things negatively. I was able to contact her parents and analyze the entire situation because it was determined from the research that she was not sharing her problems with her parents and it was mentioned in the theoretical approach that she needed behavioral therapy for getting normal.

Thus it can be said that the information that I gathered and the diagnosis I formulated assisted me in working from this theoretical perspective more effectively because I found that she was not making good relations with any of her relative or friend because she was thinking that they were not sincere with her. I found that behavioral theory can change her attitude and thinking perspective so that the rate of depression can be reduced.

Counseling Goals: The goals of the counseling include

· The cognitive-behavioral goal is important for the African American client because they are facing depression due to cultural differences just like this client

· Manage the condition in such a manner that the client becomes able to make good relation with her parents and relatives

· Motivate the client for practicing positive thinking to gains satisfaction in the life

The diagnosis process helps me in the determination of the counseling method because these are the therapies that are being used for the treatment of depression. Black people are majorly facing this mental issue and research and experiments have proved that cognitive-behavioral therapy and all these goals are helpful in the counseling of African American patients (Elion, 2012). 

The negative thoughts of the client indicated to me that the goal of counseling should be to motivate the client for practicing in positive thinking to gains satisfaction in her life. I have considered it efficiently because I was experienced in dealing with African American people for their depression due to criticism for skin color. The theory has claimed that behavioral therapy is needed that has already found that it would change the thinking process. Thus, it has been found that theoretical approach has helped me in selecting the diagnosis and counseling of the depression.

For each goal reflective of the theoretical approach, is for the first goal to help her “gain a better understanding of her behavior and motivations of others. This will help her to be able to face her fears.” (American Psychological Association, 2017). The second goal will help her solve problems to cope with difficulty situations and she would be able to role-play to help with potential problems she way encounter in the future. Finally, the third goal will help her recognize her negative thinking and allow her to reevaluate her thinking in a positive perspective. This will help her to relax her mind and body (American Psychological Association, 2017).

References

American Psychological Association. (2017). What Is Cognitive Behavioral Therapy? American Psychological Association. https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral.

Elion, A. A., Wang, K. T., Slaney, R. B., & French, B. H. (2012). Perfectionism in African American students: Relationship to racial identity, GPA, self-esteem, and depression. Cultural Diversity and Ethnic Minority Psychology, 18(2).

Keenan, K., Culbert, K. M., Grimm, K. J., Hipwell, A. E., &Stepp, S. D. (2014). Timing and tempo: Exploring the complex association between pubertal development and depression in African American and European American girls. Journal of abnormal psychology, 123(4)

Kendall, A. D., Zinbarg, R. E., Bobova, L., Mineka, S., Revelle, W., Prenoveau, J. M., &Craske, M. G. (2016).Measuring positive emotion with the mood and anxiety symptom questionnaire: psychometric properties of the Anhedonic Depression Scale. Assessment, 23(1),

Gerstner, R. M., Lara-Lara, F., Vasconez, E., Viscor, G., Jarrin, J. D., & Ortiz-Prado, E. (2020). Earthquake-related stressors associated with suicidality, depression, anxiety and post-traumatic stress in adolescents from Muisne after the earthquake 2016 in Ecuador. BMC psychiatry, 20(1),

Holliday, R. C., Braithwaite, R. L., Yancey, E., Akintobi, T., Stevens-Watkins, D., Smith, S., & Powell, C. L. (2016). Substance use correlates of depression among African American male inmates. Journal of health care for the poor and underserved, 27(2A)

Prather, C., Fuller, T. R., Marshall, K. J., & Jeffries IV, W. L. (2016).The impact of racism on the sexual and reproductive health of African American women. Journal of Women’s Health, 25(7)
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